In her recent book Amazing Grace, author Kathleen Norris tells of a discovery that her family made about her maternal grandfather, a physician.

“My mother says that she and her mother were surprised to find, after my grandfather died, several prayer books included in his medical library. It seemed that when he traveled to farmhouses by buckboard (and later by Model T), families would ask him to say prayers over the sick and dying.”

How many Americans nowadays have ever experienced their doctors praying for or with them? I certainly have not and I strongly suspect that you have not either.

And yet there’s evidence that many of us would welcome physicians’ prayer. At least one survey shows an astoundingly large percentage of those polled saying that MDs should pray with their patients.

This statistic, by the way, was one of many fascinating facts I learned last week at “Spirituality and Healing in Medicine,” a conference conducted in Boston by Harvard Medical School. This conference, attended by hundreds of people from around the country, many of them physicians, made the case for doctors taking an active interest in the spiritual life of their patients.

Dr. Herbert Benson, the well-known Harvard cardiologist, in his keynote talk, set the context of the conference in the research he and others have done over the past thirty years. This research has demonstrated the remarkable effects that spirituality can have on our physical well-being.

Dr. Benson describes his findings thus: “The research established that when a person engages in a repetitive prayer, word, sound, or phrase and when intrusive thoughts are passively disregarded, a specific set of physiologic changes ensue. There is decreased metabolism, heart rate, rate of breathing and distinctive slower brain waves.”

These changes are termed by Dr. Benson “the relaxation response.” They help to reduce stress, a strong influence in many illnesses. Thus the relaxation response has been shown to be an effective therapy in such problems as hypertension, chronic pain, and some cancer symptoms.

More and more medical practitioners are catching on to the power of the spiritual in healing. Some sixty medical schools now offer courses on spirituality. The days may have passed when a medical school graduates could say what Dr. Dale Matthews said at the conference, namely that in four years of medical school, he only heard the word “religion” mentioned once.

The same Dr. Matthews takes as established fact that “religious factors are neglected in the practice of medicine, despite patients’ wishes to have them ad-dressed.” Among other evidence, he cites a 1996 poll whereby 63 percent of adults surveyed said that physicians should talk to them about their spirituality but only ten percent had actually done so.

To make it easier for doctors to raise the subject from the beginning Dr. Matthews has developed an approach that doctors can use to bring spirituality into their dealings with patients from the beginning. Using the scheme WEB, he offers a three-part outline that can serve to raise what might be sensitive issues.

The first step is for the doctor to welcome the patient and make it clear that, whatever the person’s faith or lack of it, he or she is fully accepted. The patient can then be invited to discuss faith issues and God’s presence can be acknowledged.

Secondly, the doctor can encourage patients “to continue healthy religious beliefs and practices.” For example, if the patient has joined a prayer group, he or she can be encouraged to stay a part of it.

Finally, the physician can give an informal blessing to the patient. That might come in the form of such statements as “God bless you,” or, simply, “Shalom.”

This kind of advice, I am aware, is not going to sit well with some physicians. To them, it may seem an intrusion into territory not their own. And even if they would like to do it, many will probably feel ill at ease.

If, as a recent survey suggests, the great majority (85 percent) of medical residents feel very uncomfortable talking about death with dying patients, then surely the prospect of praying with patients would also be difficult.

In a visit to my dermatologist this week, I raised with him the question, not of praying with patients, but of asking about their spiritual life. This physician acknowledged not having done so in any explicit way but he showed strong interest in my question.

Though raised as a Catholic, he no longer goes to church. However, he retains a strong attachment to many of the religious ideas and values of his younger years. He respects Dr. Benson’s work and thinks they might be worth exploring in his own medical field.

I feel grateful to this doctor whom I do not know very well for having made it comfortable for me to raise unaccustomed questions.

Richard Griffin

At a State House forum on prescription drug coverage for elders last week, I talked to several senior advocates. Ed Schwartz of Arlington, a volunteer for Minuteman Home Care Agency, told me about one of his clients whom he has counseled.

The client is 77, a veteran of World War II who has some serious health problems. His income puts him just above the poverty level so he does not qualify for Medicaid. However he can’t afford the drugs that have been prescribed for him.

How does he handle the problem? Like most elders in this situation, he cuts back not on food or rent, but rather on the drugs. “Long run, this is detrimental to his medical problems,” says Ed Schwartz.

But Ed takes heart from the recent increase in the state’s senior pharmacy program. Elders who are eligible will find their drug allowance increasing from last year’s $750 to $1250, a rise that Schwartz calls a “real boon” for his client. Details about eligibility are available at 1 (800)  813-7787.

As this program suggests, Massachusetts is making a strong effort to provide for its elder citizens coverage that, almost everyone agrees, should be provided by the federal government. As Senator Edward Kennedy said in a speech videotaped for this forum, “Medicare is a broken promise” because it leaves so many elders vulnerable to exorbitant drug costs.

The Gerontology Institute at UMASS Boston and the Legislative Caucus on Older Citizens’ Concerns co-sponsored the forum. Its purpose, in the words of chief organizer Ellen Bruce, was “to bring together both policy makers and constituents and some drug industry people as well.”

Everyone has mixed feelings about the Massachusetts program. On the one hand, the Commonwealth has responded imaginatively and generously to serious need. As health care expert John McDonough of Brandeis University told me, “I think we in Massachusetts are making good progress.”

But, on the other hand, there is a widely shared awareness of the limitations of efforts made by any single state, however generous. Ellen Bruce puts the case well: “You can’t wait on the federal government. It probably is a collaborative effort that is needed.”

Professor McDonough, who in his time as a member of the Massachusetts House of Representatives took the lead on health care legislation, outlined masterfully the issues affecting the price and availability of prescription drugs. The continued rise in costs is highly undesirable now and can only get worse. However, he refuses to blame any one sector or group of people. “There are no heroes or villains,” he maintains.

Judith Kurland, New England Regional Director of Health and Human Services in the federal government, showed herself less reluctant to assign responsibility. “The drug companies are making more money than any other industry,” she charged. And, she claimed, some of them are using their economic power to buy up generic drug companies so as to make that cheaper option less available.

To apply brakes to runaway costs, she laid out several options. In her opinion, focusing on increased coverage would simply put more pressure on the whole health care system. Instead, she favors placing limits on the costs of drugs.  This step, however,  would run the risk of  the drug producers claiming  that cost controls will kill the industry.

Her favored option seems to be the pooling of resources. If purchasers in New England got together, she figures, they would have purchasing power equivalent to all of Spain.

Finally, Representative Harriet Chandler of the Joint Health Care Committee, emphasized the complexity of the problem and urged elders everywhere to keep lobbying the federal government for needed action.

Emphasizing the crisis that presses on elders who need drugs to maintain health, she said, “We are in a form of triage now.” Changing the metaphor she added, “We have put our finger in the dike but we need the leadership of the federal government.”

Meantime she feels proud of a new Massachusetts program that goes beyond the expanded drug coverage noted above. This new provision is aimed at so-called catastrophic costs, amounts so large almost no one can pay them.

Scheduled to start on January 1st (though some think a date in the spring is more realistic),  this emergency program has no upper limit for costs. It will include elders with incomes up to a little more than $40,000.

The next immediate challenge is to get word out about what Massachusetts is doing to help elders crushed by prescription drug costs. Over the last several years, the Senior Pharmacy Program has not enrolled nearly as many elders as expected. Of the thirty million dollars that has been allocated each year for this purpose, sixteen million is the most that has been spent. In any single year, only twenty-six thousand elders have taken advantage of the plan.

The task for elder advocates is two-fold. Spread the word about the state program to everyone you know. And let members of congress know you want Medicare expanded to cover prescription drugs.

Richard Griffin

Now that mild weather has departed this region, I am shamefully reminded of a visitor who came to our house one December evening some twenty years ago.  

Henry was a longtime friend of my parents-in-law who were already planning to celebrate Christmas with us. At our suggestion, they invited Henry, who would otherwise have been left to himself, to join us. Though our small  sparsely furnished house did not offer all the comforts that this visitor was used to, still we hoped he would have a good time.

As it turned out, however, Henry looked all evening as if he was having a perfectly miserable time. He sat politely and clearly tried to make the best of it but his distress was evident. As I came to realize only later, he felt frozen.

Then in his middle eighties, our guest was used to temperatures in his own living room almost equal to his age.  To be sitting in the home of other people who set the thermostat in the low or middle sixties was painful for him.

At one point in the evening I remember turning the heat up but I am sure it did not come close to Henry’s comfort zone.

At that time I believed it healthier to keep the temperature lower than most other Americans do. I judged that it might even be unhealthy to stay in a house that was too hot. My house would be a model of modest energy use.

Of course, I was then middle-aged and had not yet myself become very sensitive to the cold. I was used to living in a house where the thermostat was kept low. Beyond that, the house itself had poor fitting windows and doors that allowed cold air to seep through. As a result, I got used to wearing sweaters inside the house and adopted some-thing of a macho approach to coping with winter.

But in my seventies, I now know from personal experience what it is like to feel uncomfortably cold. As an elder, I have become very sensitive to cold air. Whenever the temperature outside drops, I am now prepared to raise the temperature inside far higher than ever before.

My winter clothing no longer seems adequate to me. Wind and cold air pass right through my jacket that featured, when purchased, high-tech ways of keeping out the blasts. But nowadays my poor midriff feels every bit of the cold and I shiver when it en-gulfs me. Things have gotten so bad that I feel forced to wear a hat, something I have not done since Jack Kennedy abolished them from American life.

I have also tempered my attitude about going to Florida or Arizona for the winter or even for the duration. Not without traces of prejudice, I used to ask: “Why exchange the rich cultural life normative in New England for the cultural wastelands of the south and the southwest?” Let others join flocks of snowbirds but never I.

That fundamental resolution has not changed. Now, however, I understand much better why so many of my age peers decide to go. The prospect of warmth and freedom from snow has become increasingly attractive to me. At least, let me plan to get away occasionally in order to break up the winter.

I presume that most other people in later life cannot bear the same cold that they easily accepted when younger. But, I have discovered,  the reasons for this remain unclear even to some physicians. The two doctors whom I consulted for this column surprised me by not exactly knowing the answer.

The first doctor has noticed the difference in himself. “I don’t tolerate the cold as well as I used to,” he acknowledges. And he realizes it’s not simply in his head. In his view.  “it’s a physiological issue, not just a perceptual change.”

My second contact, now a physician/journalist rather than a medical practitioner, seemed unfamiliar with the phenomenon, despite years of experience as a geriatrician. He does recognize in himself much less willingness to undergo pain for pleasure – by facing cold blasts on the ski slopes, for instance. But he pleads lack of information about feeling cold in normal settings.

Of course, the physicians know about hypothermia, the crisis that results when body temperature drops too low. Many of the causes of this condition are familiar to doc-tors, especially illnesses such as arthritis and Parkinson’s disease that limit physical activity. Certain medications can also make the body more vulnerable to the threat of hypo-thermia.

So at the end of this column I am no more enlightened about the subject than I was at the beginning. But I retain a strong sense of having changed in my response to cold weather.

And I now know first-hand what Henry went through in my living room on that Christmas day decades ago.

Richard Griffin

If you have an attic in your house, I hope it is not as cluttered as mine was until recent weeks.  That’s when we took action and had the space cleaned out of a great variety of long-nested materials.

This included books galore but also furniture and even a sculptured wooden figure.  Sorting out the material was no easy task but, with the help of experienced workers, we managed to restore the space to its original openness.

Among the items brought down from above, I appreciate the journals in which I wrote about various travels.  I depend on them to recall many features that I would otherwise have forgotten.

Unable to remember past actions clearly, I rely upon written accounts to bring back the details of my many journeys.  This enables me to recapture and relive a great variety of places, people, and things. I find names and facts, as well as my own reactions and feelings.

Perhaps I can present brief parts of two trips.  They are very different in character and time. But both indicate how I was able to capture my feelings on paper and preserve them for decades.

In July of 1998, I went to France with my wife and sister. The place that had the largest impact on us was our visit to Oradour, the village where, on June 10, 1944, soldiers in the German army slaughtered 650 men, women, and children.

It remains now as it was that day, in ruins, and viewed by silent visitors.

In reflecting on what we saw I wrote: “all this filled me with chagrin that people are capable of such merciless outrage.”  Later, I spoke of: “a renewed sense of the death of optimism –  – how can anyone possibly believe that human goodness left to itself can avail anything. We act like wild animals to one another.”

Several other stops on this French trip remain fixed in my memory. Among them my notes include Lascaux, with its caves dating from the Stone Ages; Lourdes, a pilgrimage place marked by faith and healing; and Vichy which marks the unfortunate French compromise with their Nazi conquerors.

          Let me also recall a much earlier and different kind of trip.  This was a visit to Mexico, where I stopped to see my friend Carlos. We had remained close after first becoming acquainted in college back in the late 1940’s.

In July 1974, he invited me to his new home outside Mexico City.  He had moved there, away from where I had previously visited him and his family in July of 1969. (That’s when I had shared with him one night the unforgettable vision of Neil Armstrong walking on the moon.)

During the 1974 visit, Carlos took me to “lunch” at the Banco National. (If I use quotation marks here, it’s because the meal was actually a full course dinner.) As we ate, my friend explained for me the history of the bank and its role in Mexican development.

This experience was important for me in part because it gave a clearer idea of how Carlos functioned in the business world.  It also helped me in my thinking about the role of wealth in responding to the needs of the poor.  (No answer is recorded.)

These brief reports on my travels hint at the importance of records in my life.  They continue to provide much that I could not otherwise remember.  Thanks to them, the past still lives for me, and perhaps for others as well.

Jotting down much of what seemed to me most important in my travels remains a creative part of my legacy.